BIBLIOGRAPHY

An effort to examine and understand the choice and practice of advance directives from the Igbo perspective warranted a research in form of interviews conducted with forty-three (43) Igbo persons and four (4) non-Igbos. In the analyses of the reports derived from the interviews, we arrive at three attitudes to advance directives namely: that of opposition to it, acceptance of it and then the ambivalence in such a choice. But then, these attitudes are conditioned by some factors namely:

Cultural factor, interest of the patient, peace of the relatives, the Input of the Medical personnel, awareness of advance directives, financial issue, and the question of death.

These issues are factors that will affect the practice of advance directives among the Igbo.

In discussing these issues raised from the interviews, it become obvious that in Igbo, sickness is detested and everything humanly possible must be done with the hope that the sickness will go. The Igbo never lose hope of recovery until such a person dies.

Thus, the Igbo person believes that every sickness has a cure and could be cured according to the wish of the gods. The traditional Igbo believe that a fulfilled life ends at a ripe old age and not through death, except in few cases. And more importantly, hopes are high even during serious sickness until the gods have spoken otherwise through the Dibias.

The rejection of advance directives among the Igbo is based on its seemingly indirect choice of death whereas traditionally, human life is sacred and cannot be violated by anyone irrespective of the situation. This is because human life has natural beginning and natural end. If and since it has a natural beginning, no one and indeed none has the right to tamper it. No matter the sickness, tradition demands that human life should not be taken by anyone irrespective of the challenges involved. This could be the problem in the choice of advance directives. Thus, the sick are respected and they are entitled to great care. However, some persons are likely to choose advance directives based on their desire to avoid troubling their relatives when they are critically ill.

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Nevertheless, with better knowledge and financial strength, very few Igbo are going for it and in the future, most persons will go for it. And should this be possible, it must include one‘s relative and deliberation. This is the consensus advance directive which ensures that the relatives must participate in the decision and protect the interest of the patient. No doubt, the future can see the Igbo person taking a sort of consensus advance directives.

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END NOTES

1For the Igbo, life is sacred, and everything is done to preserve it. Even if a person wants to cut it short for any reason, his relations would not allow it. A person may give directions on how his funeral would be if he dies, his living relatives can and would change the plan. Communal life is so strong as expressed thus ― I am because we are‖.

2 The Igbo people generally have high regard for the value and dignity of human life and human person. The truthfulness of the above statement can be seen in such Igbo names as: Ndubuisi, Ndukaku, Ndukauba, Nduagwuike, Ndunagu, etc. It is indeed presently against Igbo culture and tradition for an Igbo man or woman to give A PRE-DETERMINED MEDICAL DIRECTIVES TO PARENTS, SONS, DAUGHTERS, RELATIVES OR FRIENDS especially when such directives may run contrary to life or tamper with human life either because of too much sufferings in sickness or otherwise. At present ADVANCE DIRECTIVE is out of Igbo dictionary of culture and tradition unless things change in the future since culture is dynamic.

3 The only condition to accept an advance directive on the medical treatment the individual requires is if the directive requires sending the sick to specialist hospital or teaching hospital for consultant‘s treatment. It is not proper for a sick person to determine the type of treatment to receive. Decision on medical treatment should be left to medical professionals, consultants in specialized fields.

4 Capron, A.M. 2011. Advance directives. A companion to bioethics. Kuhse, H. and Singer, P. Eds. United Kingdom: Blackwell Publishing. 261.

5 May, W. 2008. Catholic bioethics and the gift of human life. Indiana: Our Sunday Visitor 302.

6 Fischer, G.S., Tulsky, J.A., and Arnold, R.M 2004. Advance directives and advance care planning. Encyclopaedia of bioethics, 3^rd ed. Post, S.G. Ed. I. USA: Macmillan Press. 74

7 Iroegbu, P. 1995. Metaphysics: The Kpim of philosophy. Owerri, International Universities Press Ltd. 312.

8 Asouzu, I.I. 2004. The method and principles of complementary reflection in and beyond African Philosophy. Calabar: University of Calabar Press. 168.

9 Asouzu, I.I. 2004.

10 Here too, we shall use the words illness and sickness interchangeably.

11 Although, there are cases whereby people die out of their sickness, the traditional Igbo believe that such a death has been predestined by the gods or that it is the sole wish of the gods to allow such a person die from the sickness.

12 Ohia, C.P. 2006. Chi-na-Eke, Eke-na-Egwurugwu: The causal principles of unity, individuation, multiplity, and differentiation in Igbo Metaphysics. Owerri: Springfield Publishers Ltd. 167-168.

112 13Ohia,169.

14 Nwala, T.U. 2010. Igbo Philosophy. Second edition. New York, Triatlantic books Ltd. 64

15 Ohia, C.P. 169

16 Zimon, H. African spiritual and religious values as the basis for interreligious dialogue. PDF Material.

17 Zimon, H. African spiritual and religious values as the basis for interreligious dialogue.

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CHAPTER FIVE

ADVANCE DIRECTIVES AND THE VALUE OF HUMAN LIFE 5.0 INTRODUCTION

A critical examination of advance directives as well as its role and place in the value of human life underscores the prevalence of some inherent problems associated with it especially when it, becomes a medical tool for the advancement of human life, in all its respects. These include its competence to promote human life since legally and ethically, it may not truly realize the respect placed on the value of human life. Again, its seeming closeness with suicide and euthanasia on some grounds reveals its absolute ambivalence in its choice and exercise by people.

Placed alongside the value of human life, advance directives raises the question of the right to life and its implication; that notwithstanding, finance and desire for comfort measures are factors that will condition either the negative and positive status of advance directives to human life. If presumably advance directives is said to be promoting the value of human life, the implication becomes that it promotes and sustains human dignity. However, advance directives will definitely pose a challenge to human dignity especially when the issue of rights: to life and autonomy clashes on the long run. This problem couched in the depreciation of human dignity is equally expressed in the inherent diverse interpretations of human hospitality.

Finally, human life cannot be complete without the function of death in contributing to human dignity. Hence, the reality of death, its expectation and preparation has some quotas to contribute to the value of human life. As a possible and major reality in advance directives, death with its widespread interpretations can help humanity to continually examine the means through which human life is protected.

Forming the evaluation of Advance directives from the African/Igbo perspectives, the elaboration of these issues shall preoccupy this chapter with the view

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of showing the current ambivalent role and place of advance directives in the promotion of the value of human life in general with specific cultural and classical interpretations.

5.1 THE LEGAL AND ETHICAL PROBLEMS OF ADVANCE